Two stark examples of the lack of appropriate mental health care for vulnerable mothers

Tania Clarence and Fiona Anderson received much attention from health and social workers, but neither received the mental health care that might have saved their children.

Tania Clarence and Fiona Anderson received much attention from health and social workers, but neither received the mental health care that might have saved their children

Last week, two high profile cases of infanticide were brought before the law.

Tania Clarence was sentenced to be detained under a hospital order, after the Crown Prosecution Service agreed to drop her murder charges last month, and accepted her guilty plea to manslaughter.

Clarence had killed her three children Olivia, four, and three-year-old twins Max and Ben last April and then attempted to kill herself.

All three of the children suffered from the the muscle-weakening condition type 2 spinal muscular atrophy, and Tania Clarence had become severely depressed while trying to cope with the challenges of their care.

Just days before Clarence killed her children in their south London home, 23-year-old Fiona Anderson drowned her three children and lay them in her bed, where they were found with ‘I love you’ written across their bodies.

She was found dead next to a multi-storey carpark in Lowestoft, Suffolk, heavily pregnant.

The agony of these two women is something which should concern us all.

The lenient sentencing of Tania Clarence and the media response to her crime shows a public, as well as a legal, consensus that her actions were not her fault. Poignantly, Gary Clarence, the childrens’ father, has stood by his wife throughout his own grief.

So how did these two tragedies happen? Could they have been prevented? These are questions which will no doubt haunt the social workers who were aware of the situations of these two women.

Because what is clear, in fact what has been stated by Clarence herself, is the fact that there was state intervention. The note that she left for her husband before her attempted suicide read:

“I cannot face going down this path watching Liv and the boys continue to get weaker. Most importantly, the interference in our lives (you know: GOSH [Great Ormond Street Hospital], NHS, Kingston/Moor Lane).”

The note shows that although public health services were clearly aware of the family’s plight, their reactions to it were ill-fitting, perhaps inappropriate, and failed to alleviate any of the burden.

Around 60 professionals were involved with the Clarence children – physiotherapists, speech and language therapists, nurses and health visitors, paediatric neurologists and local authority services.

The judge in the case acknowledged that they ‘often descended in groups’ on the family, sometimes arriving unannounced.

What was conspicuously lacking was anybody to care for Tania Clarence herself, any professional attention into her state of mind.

There is no doubt that the health workers who inundated the Clarence home had good intentions, but they had been charged with negotiating the highly sensitive area where health and social care overlap, and the tragic ending to the story shows that they did not perform this job adequately.

Similarly, the report into Fiona Anderson’s case found that although her mental health had been assessed before the birth of her first child, it had not been assessed since she had her children.

This was despite the fact that she had suffered from mental illness since she was young. In a statement, her parents said they wished more had been done to recognise their daughter’s problems.

Coroner Peter Dean said that ‘the required steps were not approached to psychologically assess’ Fiona Anderson; this is despite the fact that the family was well known to social services. In 2009 social workers tried and failed to make her give up her first child because of concerns over her mental state, but a year later formal involvement had been withdrawn.

In October the Centre for Mental Health released a report stating:

“Much previous work on perinatal mental health has focused on postnatal depression. However, it is known that mental health problems often occur during the antenatal period and that problems go beyond depression, to include anxiety, psychosis, post-traumatic stress disorder and other conditions.”

There is a real need for psychological assessments to continue after the initial perinatal period for high-risk mothers. If Tania Clarence had been visited by mental health workers trained to engage with her through her illness, she may not have found the influx of other workers so unbearable.

Earlier this year, the government recognised the need for more personalised care, releasing plans to expand the health visitor workforce by 4,200 (over 50 per cent), by

More than 5000 new midwives are now in training and we are ensuring more vulnerable women and families benefit from the support of family nurses.

Having more health visitors and midwives will help to ensure that women have personalised one-to-one care throughout pregnancy, childbirth and during the postnatal period.

What remains to be done is ensuring that cases where severe mental illness persists beyond the postnatal period are flagged up so that they can be given the appropriate care.

Ruby Stockham is a staff writer at Left Foot Forward. Follow her on Twitter

Like this article? Sign up to Left Foot Forward's weekday email for the latest progressive news and comment - and support campaigning journalism by making a donation today.